This competitive renewal application represents the merger of two successful diabetes research training programs at Washington University, DK007120 (based in the Department of Medicine) and KD007296 (based in the Department of Pathology & Immunology), into a single program entitled Diabetes and Related Metabolic Diseases (DK007120). For more than 35 years, these two T32 programs have trained a large number of biomedical scientists who have generated important insights into diabetes. To continue training outstanding scientists and physicians capable of developing novel approaches to address the striking increase in diabetes and its complications, we have integrated these two longstanding programs into one. The goal of this merged program is to provide mentoring expertise spanning model systems to outcomes research within a nurturing, structured environment that will produce independent diabetes scientists likely to change the landscape of research in diabetes and its complications. The program is directed by two PIs with complementary skill sets, one in immunology, the other in metabolism, to facilitate training opportunities in the emerging field of immunometabolism. The merged program represents the only NIH-supported mechanism for postdoctoral training in diabetes research at Washington University. The program is continually evolving in response to our ongoing assessment of its effectiveness, the needs of our trainees, and the dynamic nature of diabetes research. It is multidisciplinary and team-oriented. We propose to continue to train MD, MD PhD, and PhD scientists for 2-3 years through a structured program that leverages numerous strengths that include but are not limited to: ? An exceptional pool of 29 mentors focused on diabetes. These scientists are pursuing research in basic mechanisms, proof of principle T1 translation, T2/T3 translation to patients and practice, and T3/T4 translatio to practice and populations. This group includes two members of the National Academy of Sciences and one member of the Institute of Medicine, each having mentored trainees during this most recent funding period, and several new members representing a broad spectrum of career stage and diversity. ? A core curriculum in diabetes science required of all trainees to ensure that individuals with different backgrounds establish a standard knowledge base. ? Training with a clinical context for PhD scientists as well as those with clinical degrees in order to inform translational efforts. ? Clearly defined metrics of success that are monitored by a personalized Career Development Committee for each trainee. ? A series of mechanisms to assess quality and effectiveness of the program as well as established procedures to take action in response to the results of these assessment tools. ? A dynamically integrated short-term research training program operated in close collaboration with our NIDDK Diabetes Research Center. ? Well-established mechanisms for enhancing diversity. Our trainees are productive, having published more than 250 papers that have been cited more than 8000 times in the past 10 years. They are successful in terms of obtaining grant support for their research that includes (in the past 10 years) two R01s, several R01 equivalents (in the EU), three K01s, two K12s, two KL2s, one K99/R00, several pilot and feasibility awards, awards from the American Diabetes Association and the American Heart Association, and others. They are successful in terms of achieving productive scientific careers since our trainees enter academics (in the past 10 years) at a rate ~50-100% greater (depending on degree) than the biomedical workforce based on data cited by NIH. Our integration of two programs has achieved synergies leading to improvements in the mentor pool, enhancements in recruitment and mentoring strategies, and expanded efforts to increase diversity that collectively perpetuate a culture of multidisciplinary training with a very high likelihood of exerting a sustained and powerful influence on diabetes research.